Ch 62, 17, 48
A nurse recommends to an alcoholic that he join Alcoholics Anonymous. What is true about this organization? a. Based on a 12-step approach with a strong religious base b. A social group of ex-drinkers who befriend one another in the process of maintaining sobriety c. A religious support group that assists alcoholics during rehabilitation d. An anonymous group of sponsors who offer help to alcoholics
ANS: A
A patient has been diagnosed with alcoholism. A nurse tells him that he has a physical illness with a genetic predisposition to alcoholism, and the only effective treatment is total abstinence from alcohol. This type of approach characterizes which theory? a. Biologic b. Behavioral c. Sociocultural d. Intrapersonal
ANS: A
A urine drug screen is ordered for a patient suspected of a driving while intoxicated (DWI). What drugs are included in this screening? a. Lysergic acid diethylamide (LSD), Valium, and Percocet b. Crack, heroin, and nonsteroidal anti-inflammatory drugs (NSAIDs) c. Marijuana, amphetamines, and Elavil d. Librium, cocaine, and Zoloft
ANS: A
A young male patient taking an antipsychotic is experiencing an oculogyric crisis. The nurse prepares to administer: a. diphenhydramine. b. haloperidol. c. aripiprazole. d. risperidone.
ANS: A
An LPN is assisting with the development of a nursing care plan for a patient who has been using cocaine for 5 years. What should the nurse consider will most commonly need to be dealt with in this patient? a. Depression b. Violent behavior c. Nasal erosion d. Suicide attempts
ANS: A
Dystonic reactions, pseudoparkinsonism, akathisia, and tardive dyskinesia are types of which effect? a. Extrapyramidal symptoms b. Allergic reactions c. Idiosyncratic reactions d. Therapeutic responses
ANS: A
Narcan has been given to a person with respiratory depression who is addicted to heroin. What should the nurse be alert for indications of? a. Acute withdrawal symptoms b. Respiratory arrest c. Hypotensive crisis d. Cardiac arrest
ANS: A
The nurse is teaching a patient who is taking clozapine (Clozaril) to have weekly blood tests for the first 6 months of treatment to monitor for which potential complication? a. Agranulocytosis b. Vitamin deficiencies c. Clotting abnormalities d. Polycythemia
ANS: A
Which information about a patient should lead a nurse to suspect substance abuse? a. Abnormal liver function test result and a gastrointestinal (GI) bleed b. Positive syphilis screening result and varicose veins c. Fungal infection and a potassium level of 4.2. mEq/L d. Decreased albumin level and creatinine level of 1.2 mg/dL
ANS: A
Which protects individuals who have been successfully rehabilitated from substance abuse from discrimination related to past addiction? a. Americans with Disabilities Act (ADA) b. National Council on Alcoholism and Drug Dependence c. Bureau of Alcohol, Tobacco, Firearms and Explosives (ATF) d. American Medical Association (AMA)
ANS: A
Which type of adverse effects is present when a patient displays prolonged tonic contractions of the tongue, oculogyric crisis, and torticollis? a. Dystonic reactions b. Pseudoparkinsonism c. Akathisia d. Tardive dyskinesia
ANS: A
A nurse indicates that a urine sample is needed for screening in a case of DWI. What actions should be implemented? (Select all that apply.) a. Collection and witnessing by a staff member of the same gender b. Documented with a chain-of-custody form signed by all who handle the specimen c. Keep specimen under secure conditions if temporary storage is necessary d. Never be out of sight until someone from law enforcement takes it e. Place in a specially marked container
ANS: A, B, C
A nurse documents signs of Wernicke encephalopathy in a patient with long-term alcoholism. What do these signs include? (Select all that apply.) a. Confabulation b. Ataxia c. Delirium d. Decreasing level of consciousness e. Projectile vomiting
ANS: A, B, C, D
What important point(s) of patient education should be included about disulfiram (Antabuse) therapy? (Select all that apply.) a. The patient should return for liver function tests in 10 to 14 days following initiation of therapy. b. Headache, fatigue, and a metallic taste are common adverse effects that usually resolve. c. Avoid alcohol ingestion to prevent a reaction. d. Carefully read all labels for possible alcohol content, including perfumes and over-the-counter (OTC) medications such as cough syrups. e. Report to the healthcare provider any allergic symptoms, such as hives or pruritus.
ANS: A, B, C, D
Which is/are extrapyramidal adverse effect(s) of antipsychotic agents? (Select all that apply.) a. Spasmodic movements of muscle groups b. Mask-like expression c. Lip smacking d. Inability to sit in one place for an extended period e. Weight gain
ANS: A, B, C, D
Which sign(s) and symptom(s) may occur in neuroleptic malignant syndrome? (Select all that apply.) a. Fever b. Hypertension c. Severe extrapyramidal symptoms d. Alterations in consciousness e. Bradycardia
ANS: A, B, C, D
What does alcohol abuse in the older adult place him or her at risk for? (Select all that apply.) a. Falls b. Malnutrition c. Respiratory infections d. Bone demineralization e. Cirrhosis
ANS: A, B, D, E
Which adverse effect(s) may occur as a result of antipsychotic drug therapy? (Select all that apply.) a. Acute dystonia b. Akathisia c. Weight loss d. Neuroleptic malignant syndrome e. Hypoglycemia f. Tardive dyskinesia
ANS: A, B, D, F
A patient has completed substance abuse treatment for alcoholism. What will assist in long-term goal attainment and promote abstinence? (Select all that apply.) a. Naltrexone therapy b. Regular attendance at NA c. Regular contact with his program sponsor d. Following the 12-step program of AA e. Diazepam therapy to reduce the likelihood of DTs
ANS: A, C, D
What factors make the adolescent extremely vulnerable to substance abuse (Select all that apply.) a. Egocentricity b. Ability to use good judgment c. Poor impulse control d. Awareness of possible consequences e. Desire for peer identification
ANS: A, C, E
What is true regarding hair analysis done on an alcoholic? (Select all that apply.) a. Requires sensitive technology b. Is not reliable on treated or dyed hair c. Can determine addiction d. Can be informative in the treatment of a short-term abuser e. Can assess relapse
ANS: A, E
A 16-year-old male has been referred to the community mental health center following legal charges of driving under the influence. Which screening tests would be appropriate to use on this patient? a. Drug Abuse Screening Test (DAST) b. Adolescent Alcohol Involvement Scale (AAIS) c. Adolescent Drug Abuse Diagnosis (ADAD) d. Minnesota Multiphasic Personality Inventory (MMPI 2)
ANS: B
A nurse is counseling a pregnant cocaine abuser. What should the nurse inform this patient that she is placing her baby at significant risk for? a. Severe allergies b. Neurologic impairments c. Hearing impairment d. Higher birth weights
ANS: B
A nurse is discharging a patient with a pulmonary disorder to return home with her family. She has had a difficult time while in the hospital and has experienced withdrawal from tobacco. When the nurse tells her that community resources are available to help her to stop smoking, she says, "That's OK. I can stop whenever I want to." What does this exemplify? a. Rationalization b. Denial c. Intellectualization d. Projection
ANS: B
A patient admitted 48 hours ago has a diagnosis of gastrointestinal (GI) bleeding and is receiving IV hydration and transfusions. When making rounds, the nurse observes the patient to be having a tonic-clonic seizure. What may be the cause of the seizure? a. Low blood counts as a result of bleeding b. Alcohol withdrawal c. Alkalosis d. Inadequate nutrition
ANS: B
A patient is admitted into a substance abuse treatment center and is withdrawing from alcohol. Which statement made by the patient's family member shows a need for further education? a. "Withdrawal symptoms can begin within a few hours of discontinuation of drinking." b. "Withdrawal symptoms will improve within 24 hours." c. "Less than 1% of patients develop delirium tremens." d. "Benzodiazepines are commonly used for detoxification."
ANS: B
An alcoholic is brought into the emergency department in an intoxicated state at 2000. The day shift nurse assesses the patient to exhibit tremors, have increased blood pressure, and agitation at 0800 rounds. What do these signs and symptoms indicate? a. Major withdrawal b. Early withdrawal c. Delirium tremens d. Minor withdrawal
ANS: B
What is the rationale for administering acamprosate (Campral)? a. Withdrawal from alcohol addiction b. Maintenance of sobriety c. Improvement of renal function d. Correction of electrolyte imbalances
ANS: B
What might the positive effects of marijuana be used to treat? a. Diet control in morbidly obese patients b. Chemotherapy-induced nausea and vomiting c. Air hunger in patients with end-stage emphysema d. Early diabetic-induced cataracts
ANS: B
What must be administered before glucose infusions for a patient in alcohol withdrawal to prevent Wernicke's encephalopathy? a. Chlordiazepoxide (Librium) b. Thiamine c. Diazepam (Valium) d. Bromocriptine (Parlodel)
ANS: B
What will the nurse instruct patients who are on daily disulfiram (Antabuse) to avoid? a. All forms of cough syrup b. Alcohol c. Benzodiazepines d. Aspirin products
ANS: B
Which statement is true regarding the adverse effects associated with antipsychotic medications? a. Tardive dyskinesia is a common, reversible condition. b. Painful dystonic reactions can occur in the first 72 hours of initiation of therapy. c. Neuroleptic malignant syndrome (NMS) is a common adverse effect. d. Pseudoparkinsonian symptoms can cause Parkinson's disease.
ANS: B
Which syndrome of alcoholism is related to thiamine deficiency? a. Fetal alcohol syndrome b. Wernicke encephalopathy c. Korsakoff psychosis d. Alcoholic dementia
ANS: B
Why is a combination of antipsychotic agents with benzodiazepines useful in initial treatment of the agitated patient? (Select all that apply.) a. Antipsychotics are not effective for 2 days. b. Benzodiazepines allow for lower dosages of antipsychotic agents to be used, thereby decreasing serious adverse effects seen with high-dose therapy. c. It assists in calming the psychotic patient. d. It allows for rapid increase in dosing of the antipsychotic agents to expedite treatment of hallucinations. e. It effectively treats extrapyramidal adverse effects associated with antipsychotic agents.
ANS: B, C
A patient admitted to the hospital is exhibiting psychotic behavior. Which sign(s) and/or symptom(s) would support the diagnosis of psychosis? (Select all that apply.) a. Constant eye contact during the admission history b. Deterioration of social functioning c. Reporting that the FBI has solicited important secret information from his phone conversations d. Confirmation of hearing voices in his head e. Changing the topic of conversation inappropriately
ANS: B, C, D, E
Clonidine (Catapres) is used in treating which opioid withdrawal symptom(s)? (Select all that apply.) a. Hypertension b. Tremors c. Agitation d. Depression e. Sweating f. Nausea
ANS: B, C, E
A patient admitted to a psychiatric facility is hallucinating, pacing, and acting highly suspicious. Based on this information, the nurse will take which action(s)? (Select all that apply.) a. Use the most restrictive restraints available to subdue the patient. b. Be open and direct when handling the patient. c. Encourage a variety of interactions with others. d. Provide high-protein, high-calorie foods. e. Reinforce hallucinations.
ANS: B, D
The psychiatric nurse is educating an elderly patient and family about antipsychotic drug therapy. When providing this education, the nurse will include which statement(s)? (Select all that apply.) a. Hallucinations may be reduced within 1 week of starting. b. Rapid increase in dosages will increase the frequency of adverse effects. c. Older patients should be observed for hypertension. d. Tardive dyskinesia may be reversible in early stages. e. Full therapeutic response may require 6 to 8 weeks to be achieved.
ANS: B, D, E
A health professional colleague is suspected of having a substance abuse problem because of the person's frequent absenteeism, mood swings when at work, diminished alertness, and poor patient care. Which action(s) will the nurse take? (Select all that apply.) a. Confront the individual. b. Document specific examples of inappropriate actions. c. Avoid assigning this individual to patients with narcotic medication orders or high acuities. d. Notify law enforcement of the suspicions. e. Submit a confidential report to an appropriate supervisor.
ANS: B, E
A male patient becomes verbally aggressive and insists the nurse is poisoning him as she attempts to administer haloperidol (Haldol). Which action will the nurse take? a. Support the patient's decision to refuse the medication. b. Discreetly ask an assistant to put the medication in the patient's food. c. Firmly redirect the patient to take the medication. d. Speak privately with the patient and reinforce medication action.
ANS: C
A patient who has alcoholism with a history of heavy drinking is brought to the inpatient psychiatric unit saying that he does not know where he is or what day it is. What should the nurse suspect he is exhibiting? a. Delirium b. Alcoholic dementia c. Blackout d. Amnesia
ANS: C
A patient with schizophrenia has been nonadherent with his home medication regimen. He requires frequent admissions to the intensive psychiatric unit for treatment of acute psychotic episodes. Which medication regimen would be appropriate for this patient? a. Daily home nursing visits to administer the prescribed oral medication b. Continuous inpatient hospitalization for medication therapy c. Administration of depot antipsychotic medication d. Subcutaneous medication administration
ANS: C
A wife of a man with long-term alcoholism wants to help her husband quit drinking. The nurse tells her that an initial approach might be for a group of friends and family to confront the patient with his alcoholism. What should this group be prepared to indicate during this confrontation? a. He needs help; his drinking is out of hand. b. They are fed up with him and will no longer be his friend. c. They reject his drinking but think he is a valuable person. d. He is still their friend even if he does not stop drinking.
ANS: C
In some cases, patients will use drugs or alcohol to treat the disturbing symptoms of a psychiatric disease. What can occur in this scenario? a. A mixed-drug reaction, which may heighten the effects of both drugs b. Decreased psychiatric symptoms, which makes the psychiatric condition harder to treat c. An accidental overdose by mixing alcohol with anxiolytic medications, antipsychotic medications, or antidepressants d. An increase in psychiatric symptoms because the psychiatric drugs become less effective in the presence of alcohol
ANS: C
To what does potency of an antipsychotic medication refer? a. Severity of adverse effects associated with the drug b. Length of time that it takes to reach a therapeutic blood level of the drug c. Milligram doses used for the medication d. Effectiveness of the drug in alleviating psychotic behavior
ANS: C
What is the most common cause of nonadherence to antipsychotic pharmacologic treatment? a. Expense b. Increased symptoms of chemical dependency c. Extrapyramidal effects d. Inability of the patient to understand the need to take medications
ANS: C
What is the rationale for using methadone in the treatment of heroin abuse? a. Substitutes one opioid for another. b. Is less constipating than heroin. c. Does not give the "rush" that a person addicted to heroin is looking for. d. Is a synthetic opioid, which makes it less addicting.
ANS: C
What should be avoided to prevent the accidental activation of Antabuse? a. Aged cheese b. Pickled foods c. Mouthwash d. Chocolate candy
ANS: C
Which is an appropriate nursing intervention for a patient who has recently been prescribed clozapine (Clozaril)? a. Assess for signs and symptoms of hypoglycemia. b. Encourage a low-fiber diet. c. Measure the patient's waist circumference. d. Monitor for insomnia.
ANS: C
A nurse in the admissions unit is informed that a patient is being brought in who has been using "ice." What should the nurse assess? a. Extreme dehydration b. Coma c. Dangerous hypertension d. Violent behavior
ANS: D
A nurse working the night shift suspects that a colleague is abusing alcohol. Which action by the nurse is most important? a. "Good faith" reporting is unfaithful to a colleague. b. Reporting will result in loss of the colleague's license. c. It is not of concern, and the nurse won't be penalized for refusing to get involved. d. State guidelines may mandate to report substance abuse.
ANS: D
A patient with an alcohol addiction says, "My drinking is all my wife's fault. She makes me so crazy I just have to have a drink." What does this exemplify? a. Rationalization b. Denial c. Intellectualization d. Projection
ANS: D
During the taking of a medical history, a patient who is addicted to heroin reports he only uses the drug a few times a week. What is the nurse's best response when trying to disclose more precise information? a. "OK. You only use heroin two times a week?" b. "What do you mean when you say 'a few?'" c. "Are you saying that in a week's time would you use heroin only two times?" d. "Rate your weekly usage on a scale of 1 to 15."
ANS: D
The nurse is assessing a patient who is complaining of hearing voices. What is this patient experiencing? a. Delusions b. Flight of ideas c. Disorganized thinking d. Hallucinations
ANS: D
The nurse is assisting with the development of care plan for a patient withdrawing from cocaine. What would be the first nursing diagnosis priority for this patient? a. Altered nutrition; less than body requirements b. Risk for altered peripheral tissue perfusion c. Risk for fluid volume deficit d. High risk for self-directed violence
ANS: D
The nurse is transcribing an order for disulfiram on a patient in alcohol rehabilitation. When planning the time of day to administer this medication, the nurse will document that disulfiram be given: a. before breakfast. b. with lunch. c. before dinner. d. at bedtime.
ANS: D
Two treatment plans for abusers of alcohol and drugs are similar—90 meetings in 90 days and 12-step programs. What is the major difference in the success of the two types of programs? a. One program uses a 12-step approach, and the other program has a religious base. b. Heroin addicts have a higher success rate. c. Alcohol abusers have an easier time staying with the program. d. Relapse rates for patients using drugs other than alcohol alone are much higher.
ANS: D
What does a urinalysis that is positive for the drug tested indicate? a. It indicates illegal drug use. b. It verifies drug dependency. c. It is a violation of the individual's constitutional rights. d. It verifies whether the drug is present in the specimen.
ANS: D
What effect will occur if a patient being treated with naltrexone (ReVia) for substance abuse ingests opioids or alcohol? a. Increased euphoria b. Nausea, vomiting, and diarrhea c. Deep sedation d. An absence of the "high" associated with drugs
ANS: D
Which patient assessment will the nurse expect to observe when a patient has ingested alcohol while on disulfiram (Antabuse)? a. Unconsciousness b. Hypertension c. GI bleeding d. Severe vomiting
ANS: D
Which implementation can be used to help prevent relapse in a patient who has a substance abuse problem? a. Self-hypnosis b. Imagery c. Stress management d. Blocking
ANS:C
A nurse explains that a test that can detect substance abuse for up to 1 year after only 2 or 3 days of use is performed on ______
hair
